"GERD Uncovered: Causes, Symptoms, and Solutions for Heartburn Relief"
Gastroesophageal reflux disease (GERD) occurs when stomach contents flow back into the esophagus more than twice a week. This regurgitation can irritate the esophagus and lead to uncomfortable symptoms like heartburn and indigestion. GERD is typically diagnosed based on symptoms, with further testing such as endoscopy or pH monitoring reserved for cases that don’t respond to treatment.
For some, GERD manifests without the typical burning sensation in the throat, a condition known as silent GERD. This makes it harder to diagnose, but it can still cause significant complications if left untreated.
Recognizing GERD and Silent GERD Symptoms
The hallmark symptoms of GERD include:
Burning sensation in the esophagus
Heartburn
Indigestion
In cases of silent GERD, symptoms differ and may include:
Chronic laryngitis (inflammation of the vocal cords)
Asthma or asthma-like symptoms
Recurrent sinus infections
Chronic cough lasting longer than two months
Tooth decay
Whether classic or silent, GERD’s symptoms can significantly impact quality of life and overall health.
What Causes GERD?
Several factors contribute to GERD, either by increasing pressure on the stomach or weakening the lower esophageal sphincter (LES), the muscle responsible for preventing stomach acid from entering the esophagus.
Common Causes:
Hiatal Hernia: This structural issue allows part of the stomach to push up into the chest, impairing the function of the LES.
Pregnancy: Increased pressure on the diaphragm and stomach during pregnancy can lead to GERD.
Excess Weight: Carrying excess weight places pressure on the stomach and diaphragm, forcing acid upward.
Weak LES Closure: The lower esophageal sphincter (LES) may fail to close completely, allowing stomach acid to regurgitate into the esophagus.
Contributing Factors:
Excessive Use of Antacids and PPIs: Long-term use of proton pump inhibitors (PPIs) and antacids may lower stomach acid, reducing nutrient absorption (iron, B vitamins, and fats) and weakening the LES over time.
Diet: Certain foods and substances weaken the LES, such as:
Alcohol and smoking
High-fat meals
Milk, gluten, and nightshade vegetables
Chocolate, citrus fruits, and tomatoes
Stress: Chronic stress can exacerbate GERD symptoms by impairing digestion and LES function.
Consequences of Untreated GERD
Chronic GERD, particularly silent GERD, can have serious complications:
Persistent cough, asthma, or even fibrosis caused by ongoing irritation.
Esophageal erosion due to prolonged exposure to stomach acid, which can lead to ulcers or precancerous changes like Barrett’s esophagus.
Recognizing and treating GERD early is critical to preventing long-term damage.
Treatment Approaches for GERD
Effectively managing GERD requires a combination of lifestyle adjustments, dietary changes, and targeted treatments to address the root causes.
Behavioral Changes
Elevate your head during sleep to prevent nighttime regurgitation.
Opt for smaller, more frequent meals instead of large, heavy meals.
Avoid overeating, especially before bed.
Eat slowly and mindfully to give your digestive system time to process food properly.
Dietary Adjustments
Eliminate trigger foods through an elimination diet, focusing on avoiding:
Processed foods and high-fat meals
Acidic foods like tomatoes and vinegar
Chocolate and alcohol
Gradually reintroduce foods to identify specific triggers.
Addressing Structural Issues
For hiatal hernias, a manual maneuver performed by a skilled practitioner can help reposition the stomach and reduce symptoms.
Targeted Treatments
Surprisingly, low stomach acid—not excessive stomach acid—can be the underlying cause of GERD. Stomach acid signals the LES to close, and insufficient acid production may leave it open, allowing regurgitation. In these cases, the following treatments may be helpful:
Digestive Enzymes and HCL Supplements: Taken before meals, these can enhance digestion and support LES function.
D-Limonene (1000 mg every other day): This terpene extract from citrus fruits may coat the esophagus and reduce damage caused by acid reflux, though its mechanism isn’t fully understood.
Slippery Elm Gruel: This herbal remedy soothes and protects the esophagus, reducing inflammation and irritation.
Book a Discovery call
GERD is a complex condition, and while medications like PPIs offer temporary relief, they don’t address the root cause. Combining natural remedies with lifestyle changes and dietary adjustments can create a sustainable, long-term solution for managing GERD.
Book a free 15-minute consultation today to explore how a personalized, holistic plan can help you achieve lasting relief from GERD and improve your overall digestive health.
Dr. Michael Burstein, ND